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	<provider_name>Action Network</provider_name>
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	<author_name>Care Workers in Action</author_name>
	<author_url>https://actionnetwork.org/groups/care-workers-in-action</author_url>
	<title>Digital Release Form</title>
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	<description>I give my consent to Care Workers in Action and the Service Employees International Union, Change to Win, CLC, including all its Locals and Affiliates, (collectively, the &quot;Union&quot;) to use and publish the information I have provided to the Union. I give the Union my permission to use and publish my name, photograph, videotape, and/or any statements I have made to the Union. The Union has my permission to publish this material in print, on the Internet, over TV and radio, or through any other media. I waive any right that I may have to inspect or approve any finished products incorporating this material. I agree to release the Union from all liability and any claims that I may have arising out of the use, publication, or disclosure of this material. If I have provided my photograph and/or videotape, I further grant permission for the Union to copyright this material, and I release the Union from any liability arising from any blurring, distortion, alteration, optical illusion, or composition of my photograph or videotape.</description>
	<url>https://actionnetwork.org/forms/digital-release-form</url>
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